July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
A review of the artificial tears marketed in the US for their preservative composition, label information and cost per application
Author Affiliations & Notes
  • Avani Kathuria
    School of Pharmacy, Chapman University, Irvine, California, United States
  • Ajay Sharma
    School of Pharmacy, Chapman University, Irvine, California, United States
  • Footnotes
    Commercial Relationships   Avani Kathuria, None; Ajay Sharma, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6758. doi:
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      Avani Kathuria, Ajay Sharma; A review of the artificial tears marketed in the US for their preservative composition, label information and cost per application. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6758.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Artificial tears are the most commonly used therapy for the management of dry eye syndrome. Patients can choose from a wide array of artificial tears available as over the counter non-prescription products. However, patients invariably ask pharmacists, optometrists or ophthalmologists for advice to select an appropriate artificial tear. Besides active ingredient, the presence of preservative and the cost of therapy can be a critical determinant of artificial tear selection for a patient. Therefore, the aim of this study was to survey the artificial tears marketed in the USA for the type of preservative, label information about the preservative and the cost of the artificial tear per application.

Methods : The labels of the artificial tears marketed in the various US pharmacies were surveyed for the absence/presence and type of preservatives. The label information was also analyzed whether the preservative and its potential toxicity/advantage was mentioned on the label separately from the other inactive ingredients. The cost and volume of each artificial tear was also noted down.

Results : Among the 70 surveyed artificial tears, about 80% were multidose containing preservatives vials. Among the preservative containing drops, 40% contained benzalkonium chloride. Polyquaternium was the next most common preservative in about 24% of the drops. Purite, a vanishing type preservative, was present in about 10% percent of the drops. None of the surveyed drops mentioned preservative separately from other inactive ingredients or potential preservative toxicity on the label. Preservative-free or purite containing artificial tear drops were significantly more expensive per use compared to benzalkonium chloride or polyquaternium containing drops.

Conclusions : A wide array of artificial tears with and without preservative are available in the US market. Benzalkonium chloride remains the most common preservative despite the concerns about its corneal epithelial toxicity. Preservative-free or vanishing preservative containing artificial tears have a significantly higher cost per application. The artificial tears labels do not explicitly state the toxicity or advantages of the preservatives.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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